11 November 2015
The Genetic Testing in Epithelial Ovarian Cancer study (GTEOC) has been assessing the feasibility, cost effectiveness and the psychological impact of testing for inherited gene changes in women following ovarian cancer diagnosis. It has been assessing a model of streamlining genetic testing and counselling whilst maintaining the oversight of specialist genetic services.
People who inherit a faulty copy of BRCA1/2 gene have a higher risk of cancer. The BRCA1/2 gene tells cells to make a protein which helps repair damage to DNA but if a person inherits a faulty copy they are less able to repair damage that accumulates in their DNA over time.
“Testing women who are diagnosed with ovarian cancer for gene mutations will allow other family members to seek vital help and information in a timely manner and will become essential if the promise of personalised medicine is to be fulfilled in the future,” said study lead, Dr Marc Tischkowitz of University of Cambridge.
Between 1st July 2013 to 30 June 2015, 232 women newly diagnosed with epithelial cancer were recruited through six sites in East Anglia for BRCA1/2 testing. Women were recruited irrespective of patient age and family history of cancer. The psychosocial arm of the study utilised quantitative questionnaire and qualitative interviews.
The study recommends that all women with ovarian cancer are given genetic testing, alongside appropriate counselling, within a year of diagnosis. The results demonstrate that this testing should be coordinated by genetics services in conjunction with the woman’s clinician. But the study recommends using a less resource intensive form of genetics team-led counselling than is currently available, enabling a faster and more efficient service and allowing it to be expanded wider than is currently available.
These recommendations were shared at the NCRI Cancer Conference to the wider research community, the first step towards them being rolled out across the UK.
A major strength of the study was using the regional ‘hub and spoke’ model of using the existing network of hospitals in East Anglia to provide comprehensive access to all women in the region, not just those treated at Addenbrooke’s. Using this model means that findings from GTEOC can easily be rolled out across the country, dramatically widening access to genetic testing.
Health Economist Dr Gurdeep Sagoo of the PHG Foundation said: "More personalised medicine is undoubtedly the future, but the question for the NHS when it comes to opportunities like this will inevitably be how much does it cost, can we afford it, and should we pay for it? This work should help to provide the answer".